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Performance of prognostic risk scores in chronic heart failure patients enrolled in the European Society of Cardiology Heart Failure Long-Term RegistryCanepa, Marco ...OBJECTIVES: This study compared the performance of major heart failure (HF) risk models in predicting mortality and examined their utilization using data from a contemporary multinational registry. ... BACKGROUND: Several prognostic risk scores have been developed for ambulatory HF patients, but their precision is still inadequate and their use limited. METHODS: This registry enrolled patients with HF seen in participating European centers between May 2011 and April 2013. The following scores designed to estimate 1- to 2-year all-cause mortality were calculated in each participant: CHARM (Candesartan in Heart Failure-Assessment of Reduction in Mortality), GISSI-HF (Gruppo Italiano per lo Studio della Streptochinasi nell'Infarto Miocardico-Heart Failure), MAGGIC (Meta-analysis Global Group in Chronic Heart Failure), and SHFM (Seattle Heart Failure Model). Patients with hospitalized HF (n = 6,920) and ambulatory HF patients missing any variable needed to estimate each score (n = 3,267) were excluded, leaving a final sample of 6,161 patients. RESULTS: At 1-year follow-up, 5,653 of 6,161 patients (91.8%) were alive. The observed-to-predicted survival ratios (CHARM: 1.10, GISSI-HF: 1.08, MAGGIC: 1.03, and SHFM: 0.98) suggested some overestimation of mortality by all scores except the SHFM. Overprediction occurred steadily across levels of risk using both the CHARM and the GISSI-HF, whereas the SHFM underpredicted mortality in all risk groups except the highest. The MAGGIC showed the best overall accuracy (area under the curve [AUC] = 0.743), similar to the GISSI-HF (AUC = 0.739; p = 0.419) but better than the CHARM (AUC = 0.729; p = 0.068) and particularly better than the SHFM (AUC = 0.714; p = 0.018). Less than 1% of patients received a prognostic estimate from their enrolling physician. CONCLUSIONS: Performance of prognostic risk scores is still limited and physicians are reluctant to use them in daily practice. The need for contemporary, more precise prognostic tools should be considered.Source: JACC. Heart failure. - ISSN 2213-1779 (Vol. 6, no. 6, 2018, str. 452-462)Type of material - article, component partPublish date - 2018Language - englishCOBISS.SI-ID - 512811576
Author
Canepa, Marco |
Fonseca, Candida |
Chioncel, Ovidiu |
Laroche, Cécile |
Crespo-Leiro, Maria G. |
Coats, Andrew J. |
Mebazaa, Alexandre |
Piepoli, Massimo Francesco |
Tavazzi, Luigi |
Maggioni, Aldo P.
Other authors
Strašek, Milena |
Savnik-Iskra, Mojca |
Ravnikar, Tinkara |
Černič Šuligoj, Nataša, 1956- |
Komel, Jana |
Fras, Zlatko |
Jug, Borut, 1975- |
Glavič, Tanja |
Lošić, Renata |
Bombek, Mirko |
Krajnc, Igor, 1969- |
Krunič, Barbara |
Horvat, S., medicina |
Kovač, Damjan, 1963- |
Rajtman, Darko |
Cenčič, Vid |
Letonja, Mitja |
Winkler, Robert |
Valentinčič, Matej |
Melihen Bartolič, Cvetka |
Bartolić, Andrej |
Pušnik, Maja |
Kladnik, Majda |
Slemenik-Pušnik, Cirila |
Marolt, Apolon |
Klen, Jasna |
Drnovšek, Borut, zdravnik |
Leskovar, Boštjan, dr.med.
Topics
Heart Failure |
mortality |
Srčno popuščanje |
umrljivost |
prognosis |
risk score
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